Individual
OMAR R. KASSEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4307 HIGHWAY 66 S, ROGERSVILLE, TN 37857-3155
(423) 921-1600
(423) 921-6920
Mailing address
PO BOX 850, ROGERSVILLE, TN 37857-0850
(423) 272-9163
(423) 921-6920
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14136
TN
207Q00000X
Family Medicine Physician
20079
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0034866000
—
WV
Enumeration date
08/22/2006
Last updated
01/05/2016
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